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SAMHSA Ruling on Patient Confidentiality: What Addiction Treatment Providers Should Know


Attention addiction treatment providers! A January ruling by the Substance Abuse and Mental Health Service Administration (SAMHSA) has finally changed the regulations governing the Confidentiality of Substance Use Disorder Patient Records. The new rule went into effect on January 2, 2018.

This article will help clarify what addiction treatment providers need to know about privacy practices and how this SAMHSA ruling potentially will pave the way for more efficient payment processing.

Addiction Treatment and Privacy 

Historically, there has been a gap between the Health Insurance Portability and Accountability Act (HIPAA) and 42 Code of Federal Regulations Part 2 (CFR Part 2). While both laws deal with patient confidentiality, CFR Part 2 was created primarily to protect abusers of illegal drugs from seeking treatment for fear of prosecution. However, CFR Part 2 also protected addiction treatment facilities that received federal funding by clarifying the disclosure of drug and alcohol patient records.

Addiction treatment

While HIPAA regulates patient privacy in general healthcare, CFR Part 2 covers addiction treatment.

The gap between HIPAA and CFR Part 2 existed in the space where integrated health paradigms and electronic health records began to evolve. Both rules require written consent from patients before records and treatment modalities can be disclosed. With the modernization of Part 2, HIPAA is now better aligned with the outdated rule, which specifically targets the addiction treatment community with legal privacy protections.  CFR Part 2 now applies to both written and digital patient records.

Goals of the Part 2 Upgrade

Healthcare Informatics suggested that the goal of the SAMHSA ruling was to:

  • Help addiction treatment facilities and patients participate in some of the new integrated health models and IT infrastructures.
  • Help addiction treatment facilities share information among a cross-functional healthcare treatment team.
  • Improve privacy for substance abusers.
  • Lessen the burdens tied to consent requirements.

The Federal Register pointed out the real reason behind the evolution of the Part 2 upgrade, stating:

“Part 2 provides more stringent federal protections than other health privacy laws such as HIPAA and seeks to protect individuals with substance use disorders who could be subject to discrimination and legal consequences in the event that their information is improperly used or disclosed.”

 What Does the Part 2 Final Rule Mean for Addiction Treatment? 

The core protections for addiction treatment that govern confidentiality remain intact. Patients still must consent to have their information disclosed. However, the new rule prohibits re-disclosure of patient information to a third party without the written consent of a patient. The patient can select a “general designation” allowing for re-disclosure to other parties beyond the addiction treatment facility. These disclosures must be presented in writing, signed by the patient, and kept on file.

It is the responsibility of the addiction treatment facility to explain these rights and provide a copy of a consent form that shows exactly where patient data is being released. Note that this is a disclosure designed specifically for drug and alcohol treatment and does not cover the release of patient general health data, which is still governed by HIPAA.

The National Law Review points out:

“That this is the second final rule to be issued in less than one year – the last amendment prior to that was in 1987 – indicates SAMSHA’s desire to modernize and clarify Part 2 requirements in light of advancements in the U.S. health care delivery system.”

As rulings like this help smooth the way for an integrated approach to addiction treatment, clinicians and patients alike will benefit. Want to know more about an integrated approach that helps you refer patients to the appropriate treatment setting? Contact us to find out more about referring patients to our facilities.

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